Inner Spirit Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INNER SPIRIT CHIROPRACTIC INC

Practice address

4809 N Sheridan Rd
Peoria, IL 61614-5927

Phone

(309) 685-5777

Fax

(309) 685-5779

NPI assigned

Jul 29, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicole L Lackner, DCNPI 1710097530

Title

DC

Phone

30968557777

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole L Lackner, DC

  • Chiropractor
  • Peoria, IL
  • NPI 1710097530
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1316951635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145927",
            "telephone_number": "309-685-5777",
            "fax_number": "309-685-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145927",
            "telephone_number": "309-685-5777",
            "fax_number": "309-685-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER SPIRIT CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LACKNER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DC",
        "authorized_official_telephone_number": "30968557777",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "7227304",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemary Ince
• Thad Indermuhle
• Thomas F Ingersoll, MD
• Natalie Christine Ingle, APRN NNP-BC
• Mary Elizabeth Inman, RN
• Inspire Counseling and Wellness
• Inspirit Health PC (LifePlus MD)
• Institute of Physical and Medicine Rehabilitation
• Institute of Physical Medicine and Rehabilitation
• Integramed Medical Illinois, LLC

• Chiropractor in Peoria, IL
• Providers in Peoria, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.